Development of the Home Hospice Nursing Care Scale to Support End-of-Life Patients With Cancer and Evaluation of its Reliability and Validity

This study aimed to develop the “Home Hospice Nursing Care Scale” to assess the care provided by visiting nurses to patients with end-stage cancer and evaluate its reliability and validity. A draft of the scale was created based on a descriptive survey conducted among oncology nurse specialists and certified oncology nurses working as home-visit nurses. A questionnaire survey was administered to 1,770 home-visit nurses working at 296 functionally strengthening home-visit nursing establishments. A total of 436 valid responses were obtained (valid response rate: 24.6%). Exploratory factor analysis identified 5 factors comprising 40 items: care that supports the values of the patient and their family members, partnership involving the patient and their family members to maintain home care, care that allows for living with loved ones until end of life, care that supports the daily lives of family caregivers, and care that reconciles the feelings of those involved. Confirmatory factor analysis demonstrated that the goodness-of-fit indices of the model were as follows: GFI = 0.846, AGFI = 0.828, CFI = 0.915, and RMSEA = 0.050. Cronbach’s α coefficients ranged from 0.77 to 0.93. Criterion-related validity was verified by the Healthcare Professionals’ Attitudes towards Terminal Home Care Scale and Difficulties with Home Palliative Cancer Care Scale. The reliability and validity of the scale was verified, which demonstrates its utility. Future challenges include analyzing factors related to home hospice nursing care and developing an educational program based on the future study. Key words: home hospice, end-of-life, cancer, nursing, scale development, reliability, validity.